Introduction And Hypothesis: A presumed high failure rate of conventional procedures for prolapse has been part of the rationale for new surgical approaches. The aim of the present retrospective cohort study was to estimate the reoperation rate for prolapse within 10 years of primary surgery for prolapse.
Methods: We identified all patients who underwent primary surgery for prolapse at four large regional centers in Austria in 1997 and 1998. Hospital databases were searched to determine whether patients had been reoperated for prolapse through 2008.
Results: A total of 456 patients underwent a primary operation for prolapse in 1997 and 1998. The most common primary operation was vaginal hysterectomy with colporrhaphy (89 %). We identified 13 reoperations for prolapse, for a 10-year reoperation rate of (at least) 2.9 %. The median interval between primary and secondary surgery was 5.5 years (range 1.5-10 years).
Conclusion: The reoperation rate for prolapse after primary vaginal hysterectomy and colporrhaphy appears to be modest in this series of patients.
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http://dx.doi.org/10.1007/s00192-012-1736-9 | DOI Listing |
JAMA Surg
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.
Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.
Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.
Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.
JAMA Psychiatry
January 2025
Harvard Medical School, Boston, Massachusetts.
Importance: In the 2020 Bostock v Clayton County decision, the US Supreme Court extended employment nondiscrimination protection to sexual minority adults. The health impacts of this ruling and similar policies related to sexual orientation-based discrimination are not currently known.
Objective: To estimate changes in mental health following the Bostock decision among sexual minority adults in states that gained employment nondiscrimination protection (intervention states) compared with those in states with protections already in place (control states).
Pain Ther
January 2025
Robert Wood Johnson University Hospital/Rutgers Medical School, New Brunswick, NJ, USA.
Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.
View Article and Find Full Text PDFInt Urol Nephrol
January 2025
Department of Intensive Care Unit, School of Medicine, Tianjin First Central Hospital, Nankai University, Tianjin, People's Republic of China.
Background: Acute kidney injury (AKI) is a significant clinical condition, and ultrasound examination has emerged as a crucial non-invasive imaging method for assessing kidney status, especially in its diagnosis and management. This study aims to perform a bibliometric analysis to clarify current research trends in ultrasound assessment of AKI.
Methods: We conducted a literature search in the Web of Science database using keywords related to ultrasound examinations of acute kidney injury, up to November 15, 2023.
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